Risk factors and mortality of adults with lung cancer admitted to the intensive care unit

doi:10.21037/jtd.2018.06.165

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Title:	Risk factors and mortality of adults with lung cancer admitted to the intensive care unit
Authors:	Lai, Chih-Cheng Ho, Chung-Han Chen, Chin-Ming Chiang, Shyh-Ren Chao, Chien-Ming Liu, Wei-Lun Wang, Jhi-Joung Yang, Ching-Chieh Cheng, Kuo-Chen
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Intens Care Med Chia Nan Univ Pharm & Sci Chi Mei Med Ctr, Internal Med Fu Jen Catholic Univ Hosp, Dept Emergency & Crit Care Med Chi Mei Med Ctr, Dept Radiat Oncol[Yang, Ching-Chieh Natl Sun Yat Sen Univ, Inst Biomed Sci Chia Nan Univ Pharm & Sci, Dept Biotechnol Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Engn
Keywords:	Lung cancer intensive care unit mortality risk factor sepsis
Date:	2018-07
Issue Date:	2019-11-15 15:43:03 (UTC+8)
Publisher:	AME PUBL CO
Abstract:	Background: This study aims to investigate lung cancer patients' risk factors for: intensive care unit (ICU) admission, infectious complications and organ dysfunction in the ICU, and prognosis after ICU admission. Methods: The records of all patients with lung-cancer catastrophic-illness cards admitted to the ICU between 2003 and 2012 were reviewed. The primary endpoint was 1 -year mortality. Results: We finally analyzed the records of index-date-, age-, and sex-matched ICU-admitted (ICU+) lung cancer patients (n = 17,687) and ICU-non-admittcd (TCU-) lung cancer patients (n=35,374). The overall 1 -year mortality rate was significantly(p<0.0001) higher for ICU+ patients (49.91%) than for ICU- patients (44.86%). Most ICU+ patients (56.16%) had infectious complications and organ dysfunction (52.33%), and overall, 6,893 (38.97%) had sepsis. Independent mortality risk factors were age (>= 75 years) [adjusted hazard ratio AHR), 1.22; 95% confidence interval (CI), 1.16-1.29], male sex: AHR, 1.18; 95% CI, 1.13-1.23), recent radiotherapy (AHR, 1.09; 95% CI, 1.04-1.15), infectious complications (AHR: 1.23; 95% CI: 1.17-1.29), organ dysfunction (AHR, 1.57; 95% CI, 1.50-1.65), and hospital level (regional hospital: AHR, 1.11; 95% CI, 1.06-1.16; local hospital: AHR, 1.28; 95% CI, 1.18-1.37). Conclusions: ICU admission for lung cancer patients is associated with higher mortality. Several risk factors of mortality for ICU(+ )patients should help physicians provide patients personalized and better-informed lung cancer therapy decisions.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.21037/jtd.2018.06.165
Relation:	Journal of Thoracic Disease, v.10, n.7, pp.4118-4126
Appears in Collections:	[Dept. of Biotechnology (including master's program)] Periodical Articles

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